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Francinelee Hand 12/31/2018MIAMI BEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael Granado, City Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 Email CityClerk@miamibeach.gov December 16, 2016 Ms. Francinelee Hand 5313 North Bay Road Miami Beach, Florida 33140 SUBJECT: Human Rights Committee Dear Ms. Francinelee Hand: Congratulations! You have been appointed by the City Commission to the agency, board or committee named above for a term ending: 12/31/2018. If you are unable to accept this appointment, or have any questions, please call the Office of the City Clerk at 305.673.7411. Please read the enclosed materials carefully. Congratulations again and good luck. Regards, fael Gr-nado City Clerk cc: Saul Frances, Parking Director Marcia Monserrat, City Liaison ATTACHMENTS: Letter of Appointment Oath City Code/Ordinance section applicable to agency, board or committee City Code Section 2-22, 2-23, 2-24, 2-25, 2-26, 2-458 and 2-459 Ordinance No. 2006-3543 - Amendment to City Code Section 2-22 Miami -Dade County Code Section 2-11.1 - Conflict of Interest and Code of Ethics City Wide Permit Application - (Parking Department Form) Booklet - Guide to the Sunshine Amendment and Code of Ethics for Public Officers and Employees We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. MIAMIBEACH City of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov OFFICE OF THE CITY CLERK, Rafael Granado, City Clerk Tel: (305) 673-7411, Fax: (305) 673-7254 Email CiyClerk@miamibeach.gov TO: Ms. Francinelee Hand RE: Human Rights Committee do solemnly swear or affirm to bear true faith, loyalty and allegiance to the Government of the United States, the State of Florida, and the City of Miami Beach, and to perform all the duties of a member of the above-mentioned board or committee of the City of Miami Beach to which I have been appointed for a term ending: 12/31/2018. I have been issued a copy of section 2-11.1 of the Miami -Dade County Code (Conflict of Interest and Code of Ethics Ordinance), as well as Florida Commission on Ethics Guide to the Sunshine Amendment and Code of Ethics for Public Officers and understand that as a member of a City of Miami Beach Board and/or Committee, I must comply with the financial disclosure* requirements of Miami -Dade County or the State of Florida (depending on the board or committee on which I serve) on July 1st, following the closing of the calendar year on which I have served. s. Francinelee and Sworn to and subscribed before me this /• o / 2016. 4h� Ramon Quezada Deputy Clerk *Please visit the City of Miami Beach website at www.miamibeachfl.gov under City Clerk/Board and Committees for additional information regarding the Financial Disclosure Requirements. We are committed to providing excellent public service and safety to all who live, work and play in our vibrant, tropical, historic community. al MIAMIBEACH NAME: Hand Francinelee CITY OF MIAMI BEACH BOARD AND COMMITTEE APPLICATION FORM Last Name First Name Middle Initial HOME ADDRESS: 5313 North Bay Road Miami Beach Florida 33140 Apt No. Home No./Street PHONE: (305) 867-0706 City State Zip Code sunshine@francinelle.com Home Business Name: Address: Work Email Address Position: Street City State Zip Code Pursuant to City Code section 2-22(4) a and b: Members of agencies, boards, and committees shall be affiliated with the city; this requirement shall be fulfilled in the following ways: a) an individual shall have been a resident of the city for a minimum of six months; or b) an individual shall demonstrate ownership/interest for a minimum of six months in a business established in the city. • Resident of Miami Beach for a minimum of six (6) months Yes • Demonstrate an ownership/interest in a business in Miami Beach for a minimum of six (6) months: No • Are you a registered voter in Miami Beach: Yes • (Please circle one): I am now a resident of: North Beach • I am applying for an appointment because I have special abilities, knowledge and experience. Please list below: Former member of Commission for Women, Trustee Miami City Ballet, Patron New World Symphony, Former TV Host, Garden C • Are you presently a registered lobbyist with the City of Miami Beach? No Please list your preferences in order of ranking [1] first choice [2] second choice, and [3] third choice. Please note that only three (3) choices will be observed by the City Clerk's Office. (Regular Boards of City) Choice 1: Human Rights Committee Choice 2: Art in Public Places Committee Choice 3: • Board members are required to file Form 1 — "Statement of Financial Interest" with the State. If you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review Board, Historic Preservation Board or Planning Board, attach a copy of your currently -effectively license, and furnish the following information: Type of Professional License License Number License Issuance Date License Expiration Date Note: If applying for Youth Advisory Board, please indicate your affiliation with the Scott Rakow Youth Center: 1. Past service on the Youth Center Advisory Board: No Years of Service: 2. Present participation in Youth Center activities by your children No if yes, please list the names of your children, their ages, and which programs. List below: Child Name Age Program • Have you ever been convicted of a felony: No If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach codes: No If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money: No If yes, please explain in detail: • Are you currently serving on any City Boards or Committees: Yes If yes, which board? Human Rights Committee, Botanical Garden club, Miami City Ballet, New World Symphony. • What organizations in the City of Miami Beach do you currently hold membership in? • I am now employed by the city of Miami Beach: No Which department? • List all properties owned or have an interest in, which are located within the City of Miami Beach: Property 5313 N. Bay Road Gender: Female The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is being asked to comply with federal equal opportunity reporting requirements. Race/Ethnic Categories What is your race? Mark one or more races to indicate what you consider yourself to be. White Other Description: Are you Spanish/Hispanic/ Latino? Mark the "No" box if not Spanish / Hispanic / Latino. No Physically Challenged: No NOTE: If appointed, you will be required to follow certain laws which apply to city board/committee members. These laws include, but are not limited to, the following: o Prohibition from directly or indirectly lobbying city personnel (Miami Beach City Code section 2-459). o Prohibition from contracting with the city (Miami -Dade County Code section 2-11.1). o Prohibition from lobbying before board/committee you have served on for period of one year after leaving office (Miami Beach Code section 2-26). o Requirement to disclose certain financial interests and gifts (Miami -Dade County Code section 2-11.1). (re: CMB Community Development Advisory Committee): prohibition, during tenure and for one year after leaving office, from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom you have business or immediate family ties (CFR 570.611). Upon request, copies of these laws may be obtained from the City Clerk. "I hereby attest to the accuracy and truthfulness of the application and have received, read and will abide by Chapter 2, Article VII — of the City Code "Standards of Conduct for City Officers, Employees and Agency Members." I Francinelee Hand agreed to the following terms on Received in the City Clerk's Office by: Name of Deputy Clerk Control No. Date tv\lAM BEACH DIVERSITY STATISTICS REPORTING Name: r- NG "lee - Board Board / Committee: itzdjigA V1 12_[ )1'1 ►'s Appointment Date: 12 //1., Pursuant to City of Miami Beach Ordinance 2009-3632, the City is required to annually prepare and present a report to the City Commission identifying the City's diversity statistics. This form allows board and committee applicants and members to voluntarily self -identify their race, ethnicity, disabled status and gender. yr w► (1-kee Please check the appropriate box for each category: Gender: Male Female Race/Ethnic Categories What is your race? ican-American/Black Caucasian/White Asian or Pacific Islander Native-American/American Indian Other — Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a. [No 0 Yes Do you consider yourself Physically Disabled? MNo Yes C:\Users\CENTFraN\APPData\Local\Microsoft\Windows\Tem00rany Internet Files\Content.Out!ook\NP4J9CNX\BC minority information form 05-20-13 FINAL.doc Updated: Monday, January 26, 2015 iN i ll `i i l EAC H City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov CITY CLERK'S OFFICE CityClerk@miamibeachfl.gov Telephone: 305.673.7411 Fax: 305.673.7254 Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami - Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2) Board Member's Name: I understand that no later than July 1, of each year all members of Boards and Committees of the City of Miami Beach, including those of a purely advisory nature, are required to comply with Miami -Dade County Financial Disclosure Requirements. This means that the members of City Advisory Boards, whose sole or primary responsibility is to recommend legislation or give advice to the City Commission, must file, even though they may have been recently appointed. One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida, no later than 12:00 noon of July 1, of each year. 1. A "Source of Income Statement" 2. A "Statement of Financial Interests (Form 1)" 3. A Copy of your latest Federal Income Tax Return Failure to file one of these forms, pursuant to the Miami -Dade County Code, may subject the person to a fine of no more than $500, 60 days in jail or both. Signature Updated: Monday, April 20, 2015 Page 4 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06022014.docx �6 ate ate NA, A F B LAST NAME: City of Miami Beach Board & Committee Citywide Parking Application DATE OF APPLICATION: l Z- I / / 40 FIRST NAME: Frail Qie�'-� 1-1co\v‘d NAME OF BOARD/COMMITTEE: . v 01 an • iz1 �°1 ts {J ADDRESS: (3 / 3 130 Rottsii. WORK PHONE: HOME PHONE: CELL PHONE: VEHICLE MAKE VEHICLE MODEL VEHICLE YEAR I TAG NUMBER e.swetfr. /I. / I I understand that Board/Committee Citywide Parking entitles me to park et any parking meter both on -street and oil-srem. (metered parking lots) (fathvr understand that Citywide Parking is NOT AUTHORIZED AT ATTENDED LOTS OR GARAGES — EXCEPTION: CITY HALL GARAGE (-1755 MERIDIAN AVE). NOTE: Your license plate now serves as your "parking permit". Parking enforcement specialists are equipped with handheld and mobile LPR devices to confirm your parking permit status (valid/invalid). In order to avoid any unnecessary enforcement actions, it is Important that our records reflect the most current and accurate information regarding your vehicle license plate. Please provide us with your current vehicle information (year/make/model/license plate number). Inaccurate and/or outdated vehicle information may lead to the issuance of parking citation(s), and/or the towing of your vehicle. Applicant's Signature: �-11A,M I BEACH Last N Home Address 53 3 Home Telephone 3o Caa7 Business Name 0 First Name City BOARD AND COMMITTEE APPLICATION FORM Middle Initial 33/549 Business Address Work e phone Cellular Telepho filed Occupation City State Zip Code Email address Professional License (describe): I r/1 State Zip Code Please attach a copy of currently effective professional license. Expires: .(/' Pursuant to City Code section 2-22(4)a & b: Members of agencies, boards and committees shall be affiliated with the City. This requirement shall be fulfilled in the following ways: a. An individual shall have been a resident of the City for a minimum of six months; or b. An individual shall demonstrate ownership/interest for a minimum of six months in a business established in the City for a minimum of six months. / • Resident of Miami Beach for a minimum of six (6) months: Yes [k ,or No Lj • Demonstrates ownership/interest in a business in Miami Beach for a minimum of six months: • Are you a registered voter in Miami Beach: Yes 14or No • I am now a resident of: North Beach South Beach Middle Beach ar- • I a applying for an ,appointment because I have special ablities, knowledge and expe iere. ,, :.0 or cd .s -- ,9.1 ,t( C( , • Are you presentlya registered lobbyist with Cityvit y o of Beach? Yes ,o ` te f �� g l'f I 1 y or No .a. else list below: YCl rs i' co u( C� ordeof ranking [�] first choice Please list your preferences in only three l3) choices will be observed by the Office of the Cit Clerk [2] second choice, and [3] third choice. Please note that 0 Affordable Housing Advisory Committee 0 Art in Public Places Committee 0 Audit Committee 0 Board ofAd'ustment * 0 Bud. et Adviso Committee ❑ Committee on the Homeless 0 Committee for Qualit Education in MB ❑ Convention Center Advisory Board 11' 'Aural Arts Council Design Review Board 0 Disabilit Access Committee 0 Health Advisory Committee ❑ Health Facilities Authorit Board 0 His .anicAffairs Committee 0 Historic Preservation Board 0 Housin. Authorit 0 Human Ri. hts Committee 0 LGBT Adviso Committee 0 Marine & Waterfront Protection Authority ❑ Miami Beach Commission for Women 0 Normandy Shores Local Government Nei. hborhood Improvement 0 Parks and Recreation Facilities Board °O 0 Personnel Board 0 Plannin. Board* 0 Police Citizens Relations Committee roduction Indust Council rii ister Cities Pro. ram Sustainabilit Committee 0 Transportation, Parking, & Bicycle -Pedestrian Facilities Committee isitor and Convention Authorit ❑ Youth Commission *If* Board members are required to file Form 1 — "Statement of Financial Interest" with the State. you seek appointment to a professional seat (e.g., lawyer, architect, etc.) on the Board of Adjustment, Design Review following information: Board, Historic Preservation Board or Planning Board, attach a copy of your currently -effectively license, and furnish the Type of Professional License License Issuance Date License Number License Expiration Date F:ICLERI$ALL1aFORMSIBOARD AND COMMITTEES\BC APPLICATION REVISED 061420 6.docx °O Note: If applying for the Youth Center positions of the Parks and Recreations Facilities Board, please indicate your affiliation with the Scott Rakow Youth Center and/or the North Shore Parks Youth Center: • Please describe your past service with the City's Youth Centers (include dates of service): • Present participation in Youth Center activities by your children: Yes No If yes, please list below the names of your children, their ages and the programs in which they participate: Child's name: Age: Program: Child's name: Age: Program: • Have you ever been convicted of a felony? Yes La or No If yes, please explain in detail: • Do you currently have a violation(s) of City of Miami Beach Code? Yes or NoI If yes, please explain in detail: • Do you currently owe the City of Miami Beach any money? Yes Z3 or No ei If yes, explain in detail: • Are you currently serving on any City Board or Committee? Yes Zior No If yes, which board/committee? cap ,A4(D( 04 C4 tOOay((-t • In what organization(s) in the City of Miami Beach do you currently hold m M6 &OA e',,644- C -6n /AlIICi�r�( I Name Position b rship 61.a uJork‘ Name • List all properties owned or in which yitik have an interest within the City of Miami Beach: ©yvLP / 3 I 1Jo lc Position • Are you now employed by the City of Miami Beach? Yes Z1 or No Which department and title? • Pursuant to City Code Section 2-25 (b): Do you have arent �, spouse , child brother or sister who is employed by the City of Miami Beach? Yes rjor No r If "Yes," identify person(s) and department(s): The following information is voluntary and is neither part of your application nor has any bearing on your consideration for appointment. It is being asked to comply with City diversity reporting requirements. Gender: Male Female Race/Ethnic Categories What is your race? African-American/Black Caucasian/White Asian or Pacific Islander Native-American/American Indian Page 2 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx Other — Print Race: Do you consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a. El No Yes Do you consider yourself Physically Disabled? J No Yes NOTE: IF APPOINTED, YOU WILL BE REQUIRED TO FOLLOW CERTAIN LAWS THAT APPLY TO CITY BOARD/COMMITTtt MEMBERS. THESE LAWS INCLUDE, BUT ARE NOT LIMITED TO: o Prohibition from directly or indirectly lobbying City personnel (Miami Beach City Code section 2-459). o Prohibition from contracting with the City (Miami -Dade County Code section 2-11.1). o Prohibition from lobbying before the board/committee you have served on for period of one year after leaving office (Miami Beach City Code section 2-26). o Requirement to disclose certain financial interests and gifts (Miami -Dade County Code section 2-11.1). o CMB Community Development Advisory Committee: prohibition, during tenure and for one year after leaving office, from having any interest in or receiving any benefit from Community Development Block Grant funds for either yourself, or those with whom you have business or immediate family ties (CFR 570.611). o Sunshine Law - Florida's Government -in -the -Sunshine Law was enacted in 1967. Today, the Sunshine Law regarding open government can be found in Chapter 286 of the Florida Statutes. These statutes establish a basic right of access to most meetings of boards, commissions and other governing bodies of state and local governmental agencies or authorities. o Voting conflict — Form 8B is for use by any person serving at the county, city or other local level of government on an appointed or elected board, council, commission, authority or committee. It applies equally to members of advisory and non -advisory bodies who are presented with a voting conflict of interest under Section 112.3143, Florida Statutes. Upon request, copies of these laws may be obtained from the City Clerk. I HEREBY ATTEST TO THE ACCURACY AND TRUTHFULNESS OF THE APPLICATION; AND I HAVE RECEIVED, READ AND WILL ABIDE BY CHAPTER 2, ARTICLE VII, OF THE MIAMI BEACH CITY CODE, ENTITLED "STANDARDS OF CONDUCT FOR CITY OFFICERS, EMPLOYEES AND AGENCY MEMBERS AND ALL OTHER APPLICABLE COUNTY AND/OR STATE LAWS AND STATU S ACCORDINGLY." ( /f Received in the Office of the City Clerk by: Date Name of Applicant ('LEASE PRINT) 4c4...SOY)Lizt,ei L Name of Deputy Clerk %Z;4 Control No. /7. /‘ date ATTACH A CURRENT RESUME, PHOTOGRAPH AND A COPY OF ANY APPLICABLE PROFESSIONAL LICENSE. ATTACH ADDITIONAL SHEETS, IF NECESSARY, TO PROVIDE REQUIRED INFORMATION. Page 3 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx MIAMI BEACH City of Miami Beach 1700 Convention Center Drive, Miami Beach, Florida 33139, www.miamibeachfl.gov OFFICE OF THE CITY CLERK CityClerk@miamibeachfl.gov Telephone: 305.673.7411 Fax: 305.673.7254 Acknowledgement of fines/suspension for Board/Committee Members for failure to comply with Miami - Dade County Financial Disclosure Code Provision Code Section 2-11.1(i) (2) Board Member's Name: F U-YI (Al the, ire- I understand that no later than July 1, of each year all members of Boards and Committees of the City of Miami Beach, including those of a purely advisory nature, are required to comply with Miami -Dade County Financial Disclosure Requirements. This means that the members of City Advisory Boards, whose sole or primary responsibility is to recommend legislation or give advice to the City Commission, must file, even though they may have been recently appointed. One of the following forms must be filed with the City Clerk of Miami Beach, 1700 Convention Center Drive, Miami Beach, Florida, no later than 12:00 noon of July 1, of each year. 1. A "Source of Income Statement" 2. A "Statement of Financial Interests (Form 1)" 3. A Copy of your latest Federal Income Tax Return Failure to file one of these forms, pursuant to the Miami -Dade County Code, may subject the person to a fine of no more than $500, 60 days in jail or both. Signat �NikiuViv. ,%r� ((/?j"l/e Updated: Tuesday, October 04, 2016 Page 4 of 4 F:\CLER\$ALL\aFORMS\BOARD AND COMMITTEES\BC APPLICATION REVISED 06142016.docx MIAMtBEACH Name: DIVERSITY STATISTICS REPORTING Board / Committee: �+ Appointment Date: Pursuant to City of Miami Beach Ordinance 2009-3632, thideCiCity yi is rg q i edyto annually prepare and present a report to the City Commis applicants and members to voluntarily statistics. This form allows board and committee app self -identify their race, ethnicity, disabled status and gender. Please check the appropriate box for each category: vnet 12- Gender: Male 0 Female 0 Race/Ethnic Categories What is your race? 0 African-American/Black 0 Caucasian/White 0 Asian or Pacific Islander 0 Native-American/American Indian 0 Other — Print Race: DoY ou consider yourself to be Spanish, Hispanic or Latino/a? Mark the "No" box if not Spanish, Hispanic, Latino/a. 0 No D Yes Do you consider yourself Physically Disabled? D No Dyes C:\Users\CENTFraN`,AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.0utlook\NP4 J9CNX\BC minority information form 05-20-13 FINAL.doc Updated: Monday, January 26, 2015